The Supreme Court's ruling in June overturning Roe v. Wade immediately ushered in massive changes in American life, especially in Republican-controlled states. But it didn't alter the constitutional principle that federal law supersedes state law, even on this most contentious issue. That, in a nutshell, is the valid position of the Biden administration in suing Idaho over its imminent anti-abortion law, saying it violates a federal requirement that doctors provide women with medically necessary treatment during medical crises.

The federal Emergency Medical Treatment and Labor Act of 1986 simply requires hospitals to provide medical care when a pregnant woman's life or health is at stake. That care includes abortion, if that's what is medically necessary. Who would argue with that standard?

Idaho's controlling Republicans, that's who. The state's law banning abortion that goes into effect there on Aug. 25 does contain exceptions for the health of the woman. But critics say the standards are so vaguely written as to be useless to doctors trying to figure out whether a given prognosis for a pregnant woman would justify ending the pregnancy under the terms of the law.

The issue is especially dicey because, in an unusual construct, the Idaho law begins with the presumption that any abortion is illegal, then puts the burden of proof on the doctor to show that it was medically justified.

Consider how that applies to, say, ectopic pregnancies, in which a fertilized egg attaches outside the uterus. Such pregnancies, which can never result in live birth, don't threaten the woman's life early on but will definitely pose a danger to her as the doomed fetus grows. Doctors who reasonably decide it's safer to end such pregnancies early, before the medical crisis begins and when the abortion procedure is simpler, will be rolling the dice and risking prison time based on the competence, ideology or mood of local prosecutors.

These are the kinds of real-life quandaries that anti-choice extremists tend not to consider when they construct these laws. But unlike Idaho's upcoming state law, the federal law is clear: Hospitals that accept Medicare — meaning, the vast majority of them — are required to provide life-saving treatment to the patient at hand, including abortion services, if medically necessary.

Idaho officials are fighting the suit, saying, in the words of Republican Gov. Brad Little: "Our nation's highest court returned the issue of abortion to the states to regulate - end of story."

Wrong. Justice Samuel Alito's majority opinion overturning Roe returned the abortion question "to the people and their elected representatives." By definition, that includes Congress and the superseding laws it passes.

But then, if the risk of women suffering and dying because of a poorly drafted and ideologically extreme state law doesn't move anti-choice Republicans to reason, why would they respect the clear constitutional imperative of federalism that the GOP once venerated?

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